AIDS Stigma Grips Asia

A volunteer promotes messages of HIV prevention and safe sex on Valentine’s night in Bangkok.

Courtesy of UNAIDS

One in two Cambodians living with HIV say they have lost their jobs or income because of the deadly virus they are carrying.

In China, up to 35 percent of youngsters living with HIV lament that their teachers discriminate against them. In Burma, as high as 45 percent of those surveyed complain they face verbal insults and threats.

Stigma and discrimination against people living with HIV remains widespread in Asia and the Pacific, according to a new study released Monday by UNAIDS, a joint United Nations program on HIV/AIDS.

“Stigma and discrimination based on HIV status, sexual orientation, or lifestyle choice is unacceptable and hampers the AIDS response,” said UNAIDS Executive Director Michel Sidibe.

The study was based on surveys in nine countries—Bangladesh, Cambodia, China, Fiji, Burma, Pakistan, the Philippines, Sri Lanka, and Thailand—and provides the first large-scale regional comparison of standardized HIV-related stigma indicators.

“The Stigma Index is an important initiative to increase the evidence base that will enable governments and civil society partners to work more effectively to reduce HIV-related stigma and discrimination,” Sidibe said.

Although data in the analysis often differs widely depending on country context, the analysis shows that "stigma and discrimination remain rife across the region as a whole and are evidenced in many environments, including family and community life, as well as employment and health care," according to the report.

For example, the study found that high percentages of people living with HIV had lost jobs or income in the last 12 months based on their HIV status: from 16 percent of those surveyed in Fiji to 50 percent in Cambodia.

Data also showed that many people living with HIV avoided clinics and hospitals for fear of being discriminated against because of their HIV-positive status.

In health-care settings, confidentiality and involuntary testing for HIV were also cited as issues of concern.

The report pointed to discrimination as "a reality" for all ages.

Up to 35 percent of people living with HIV in China under the age of 25, for example, reported that teachers were discriminatory to them based on their HIV status.

A pervading issue across the nine-country analysis was the incidence of verbal insults and threat felt by people living with HIV, with 45 percent of those surveyed in Burma saying they had experienced such discrimination.

In a separate report, UNAIDS said coverage of antiretroviral therapy—treatment of infected people using anti-HIV drugs—remains low.

While the number of people living with HIV receiving antiretroviral therapy in Asia and Pacific almost tripled from 280,000 in 2006 to 739,000 in 2009, only one in three people living with HIV had access to treatment in the region that year.

With 60 percent of people eligible for treatment in the region still not yet able to access it, "need for scale up is urgent," the report said, citing ample evidence of the benefits of antiretroviral therapy for people living with HIV.

"In China, for example, it is estimated that the provision of free antiretroviral therapy has led to a 64 percent drop in AIDS-related mortality," it said.

A recent study, the report said, has shown that the risk of transmitting HIV to an uninfected sexual partner can be reduced by as much as 96 percent, when people living with HIV receive timely and effective antiretroviral therapy.

Early treatment is hampered by stigma, discrimination, and inaccessible service delivery as well as funding constraints, the report said.

With 4.9 million people living with HIV in the region, six countries account for over 90 percent of people eligible for treatment: China, India, Indonesia, Burma, Thailand, and Vietnam.

In Asia, most of the new infections comprise injecting drug users, men who have sex with men, and sex workers and their clients.

"[A]nd ongoing transmission to the female partners of drug users and the clients of sex workers is becoming apparent," it warned.